The effect of microwave and bipolar radio-frequency ablation in the surgical treatment of permanent atrial fibrillation during valve surgery.

BACKGROUND: Atrial fibrillation (AF) is a frequent problem in patients undergoing valve surgery. This study compared microwave and bipolar radio-frequency ablation of the left atrium in AF patients undergoing valve surgery.
METHODS: Patients who required left atrial ablation for permanent AF (duration > 6 months) during valve surgery were randomized to a microwave group (n = 94) or a radio-frequency group (n = 93). Regular follow-up was carried out at 3, 6, 9 and 12 months post-procedure and annually thereafter.
RESULTS: There were 4 postoperative deaths in the microwave group and 2 in the radio-frequency group. The median follow-up for all patients was 24.0 months (range: 12-36.0 months). Freedom from AF recurrence was significantly higher in the radio-frequency group than in the microwave group at 3 months (85.7 vs. 72.2 %, P = 0.026), 6 months (87.9 vs. 73.3 %%, P = 0.013), 9 months (84.6 vs. 68.9 %, P = 0.012), 12 months (84.6 vs. 67.8 %%, P = 0.008), and 24 months (88.7 vs. 71.2 %, P = 0.022) and at the latest follow-up (81.3 vs. 65.6 %, P = 0.016).
CONCLUSION: Bipolar radio-frequency ablation is superior to microwave ablation for the treatment of permanent AF in patients undergoing valve surgery. © Georg Thieme Verlag KG Stuttgart · New York.

RCT Entities:   Population Interventions Outcomes